Regulation of beta-adrenoceptors by catecholamines in the rabbit skeletal muscle

Mechanisms underlying development of spatially distributed chronic pain (fibromyalgia)

Chronic fibromyalgia (FM) pain is prevalent (estimated as high as 13%), predominantly affects women, and is associated with a variety of focal pain conditions. Ongoing FM pain is referred to deep tissues and is described as widespread but usually is maximally located within a restricted region such as the shoulders. Palpation of deep tissues reveals an enhanced nociceptive sensitivity that is not restricted to regions of clinical pain. Similarly, psychophysical testing reveals allodynia and hyperalgesia for cutaneous stimulation at locations beyond regions of clinical pain referral. The combination of widely distributed clinical pain and generalized hypersensitivity is highly disabling, but no satisfactory treatment is regularly prescribed. A thorough understanding of mechanisms will likely be required to develop and document adequate therapies. The generalized hypersensitivity associated with FM has focused considerable interest on central (CNS) mechanisms for the disorder. These include central sensitization, central disinhibition and a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis. However, the central effects associated with FM can be produced by a peripheral source of pain. Chronic nociceptive input induces central sensitization, magnifying pain, and it activates the HPA and the sympathetic nervous system. Chronic sympathetic activation indirectly sensitizes peripheral nociceptors and sets up a vicious cycle. Thus, it appears that central mechanisms of FM pain are dependent on abnormal peripheral input(s) for development and maintenance of this condition. A substantial literature defines peripheral-CNS-peripheral interactions that are integral to FM pain. These reciprocal actions and related phenomena of relevance to FM pain are reviewed here, leading to suggestions for testing of therapeutic approaches.

Intramuscular hypoperfusion, adrenergic receptors, and chronic muscle pain

Despite a high prevalence of chronic muscle pain disorders such as fibromyalgia and regional myofascial pain, there is still limited knowledge about the factors that initiate and perpetuate these pain states. Although there are also likely to be downstream neuropathic changes in the central nervous system and spinal cord that sustain and exacerbate the pain states known as fibromyalgia, the focus of this critical review is on studies that examined the connection between both fibromyalgia and regional myofascial pain and sympathetic function. Specifically, we looked at studies that described Raynaud-like symptoms, cardiovascular dysfunction and altered intramuscular perfusion in chronic muscle pain. Our analysis showed that although the first 2 phenomena were intermittently present, a prominent and consistent feature for regional myofascial pain and to a lesser degree for fibromyalgia was intramuscular hypoperfusion. Several hypotheses can be offered why this hypoperfusion exists, and additional studies comparing and contrasting these theories are needed. This review focuses on one of these theories, namely, agonist-induced beta-adrenergic receptor desensitization as an explanatory model for hypoperfusion. What cannot be done at this time and is needed in the future is to compare and contrast to what degree the regional muscle pain disorder (myofascial) is similar or different from the more generalized disorder (fibromyalgia).

Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation

The aim was to compare haemodynamic responses in trapezius muscles to cold pressor stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold pressor and mock) trials were performed in a randomly assigned sequence. In the cold pressor trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold pressor stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold pressor stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold pressor stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia.

Cyclic AMP accumulation in rat soleus muscle: stimulation by beta2- but not beta3-adrenoceptors

The beta-adrenoceptor subtypes involved in cyclic AMP accumulation in rat soleus muscle were studied using beta1- beta2- and beta3-adrenoceptor agonists and antagonists. Responses to (-)-isoprenaline were antagonised by (-)-propranolol (p KB = 8.32 at 0.1 microM) and by erythro-DL-1(7-methylindian-4-yloxy)-3-isopropylaminobuta n-2-ol (+/-)-ICI 118551) (pKB = 9.38 at 10 nM and 9.65 at 100 nM) but not by 2-hydroxy-5(2-((2-hydroxy-3-(4-((1-methyl-4-trifluoromethyl)1H-imidazole -2-yl)-phenoxy)propyl)amino)ethoxy)-benzamide monomethane sulfonate ((+/-)-CGP 20712A at 10 nM or 100 nM). The beta3-adrenoceptor agonist sodium-4-[-2[-2-hydroxy-2-(-3-chlorophenyl)ethylamino]propyl]phenoxya cetate (BRL 37344 at 10 pM or 10 microM) caused no significant change in basal cyclic AMP levels and had no effect on the level of cyclic AMP accumulation stimulated by (-)-isoprenaline, zinterol or forskolin. (-)-Isoprenaline pretreatment (400 microg kg(-1) h(-1), 14 days) abolished responses to (-)-isoprenaline (10 microM) and zinterol (1 microM) while BRL 37344 had no effect in either isoprenaline or vehicle-treated groups. These results show that beta3-adrenoceptor agonists do not stimulate cyclic AMP accumulation in rat soleus muscle and that (-)-isoprenaline induced increases in cyclic AMP levels are mediated predominantly by beta2-adrenoceptors. This suggests that the previously reported increase in glucose uptake by beta3-adrenoceptor agonists in skeletal muscle does not involve direct stimulation of adenylate cyclase.